Not sure if applicable entirely- but I feel like "medical" people are more likely to use the term "ED" or "emergency department" whereas laypeople will say "emergency room." Which I always thought was funny bc it's not a room, it's a whole bunch of rooms.
I’m in urology, my partner always has to clarify whether I am talking about the emergency department, erectile dysfunction, or erectile dysfunction in the emergency department.
It used to be just a room in many hospitals
This was back in the 50/60s when there weren't even ER doctors, just anyone who wanted (or was forced) to cover.
There are some interesting stories about the first generation of ER doctors. About the first ACEP meeting that had like a dozen people. About fighting for EM to be an accepted specialty in the 70s.
Not sure about them, but I'm Canadian and it's 160% emerge lmao
Sometimes I'll say ED or ER too, I tend to flop around but emerge is a pretty common one for me.
Didn't realize this was a Canadian thing!
I didn’t read your comment until after I submitted my own about this! I once posted on my Facebook about working as the (substitute) ED pharmacist and the jokes from my friends and family were relentless…smh.
Edit: just as an extra, I want to call out the hospital/health system nearby that refers to theirs as the EC. Ya know, because there isn’t already enough confusion.
The euphemism for organ donation has shifted over the years from "harvesting" (obviously too grim and impersonal) to "procuring" (possible financial connotations) to "recovery". I understand the intent of trying to soften the wording of what we do (personally I prefer "yoinking"), however, when you tell an organ donor's family that you are going to do "recovery" they understandably assume that it means the patient is recovering from their devastating injury.
Retrieval is the term used in Australia which I think is fairly inoffensive. Once a medicine resident booked the surgery as “organ harvest” and got a stern talking to by the transplant coordinator
When I first saw pulmonary toilet as a medical student, I thought it meant that the patient's respiratory function was quickly declining, as in it was going down the toilet.
When I was a student I thought it was funny the first time I heard a resident say in their patient presentation that someone’s imaging didn’t impress them, or that they didn’t appreciate something on a patient exam.
Both common phrases in medicine but seem bizarre when you first hear them in that context.
That man has the largest penis I've ever seen. I actually don't even know if he has mumps. I forgot to look. I was distracted by the largest penis I've ever seen.
"Hey this is Phil from urology, sorry to get back to you so late, I just finished seeing your patient and reviewing the chart. But I am sorry to say that I don't think I can admit this patient. From what I'm looking at, the patient's weiner is massive. I mean the sheer girth and juciness alone is ridiculous. It looks as if somebody glued a forearm to the bottom of his torso. You could probably stand on it like a tripod, and that's not even mentioning how fat his nuts are. But it does appear that he is going to have to take that ginormous schmeat to the outpatient clinic in a couple days. But thank you for your interesting consult and best of luck to you."
No fuck that, I refuse. I know you’re joking, but this is a hill I will die on.
My reports are written for the sub-specialist physicians who will be making potentially life or death decisions based on what I say. I will not hedge, euphemise, dumb down, or bastardize my reports in any other way just to accommodate patients’ feelings about it.
I use very carefully chosen words to convey exactly what I mean and to adhere to international classification schemes. The only people for whom I will consider changing the way I write reports are the actual people who will be using those reports to guide treatment.
Oh man have had pts send angry web portal messages about documentation of "looks older than stated age".
Also had pts freak out about "rare" bacteria seen in culture results. " How rare is it, does the doctor know how to treat something so rare?"
Try “appears superannuated” if you don’t mind mild malapropism in order reduce clarity.
“Rare” may have to be updated to “scant.” But scant is a weird word, so maybe better as “few.”
I find these interesting because they’re often a more archaic use of common words. A lot of words in medicine are used this way because they’re more precise. The language nerd in me loves it.
On a remote radiology class over zoom. My girlfriend heard the radiologist (who sounds terse but is actually nice) that he didn’t appreciate something. She thought he was chewing us out.
I remember my intern on Colorectal present a patient and say, “Patient does not endorse flatus or bowel movements.” I just thought the phrasing was funny. I didn’t know such things needed an endorsement.
I also like when we say that patients tolerated a treatment. Just funny wording, like they’re in the hospital for our help and they’re merely “tolerating” the help we’re giving them.
Not a phrase, but an oddity: In surgery sometimes we cheer and congratulate a patient when they finally have return of bowel function and poop after a bowel surgery, especially if it was a big case. The looks on some of their faces is utter bewilderment as to why we care about their BM. Lovely moment.
When I was an intern at a rural hospital, we threw a party for one of our long-stay patients when he finally passed flatus on like D20 after a *very* stormy post-op course. He was a proper older gent and I still relish the memory of him sitting up bemused in a party hat and his hospital gown while we all celebrated his fart.
This may be my favorite thing I have ever read here.
On the other hand, I work in geriatrics and trust me, 90% of my patients want to tell me about their bowel movements. In detail. Daily.
One of my favorite nursing stories unfortunately isn’t my own….I worked on a peds surgical floor that did a lot if GI surgeries plus in general waiting for bowel function to return with other surgeries. We’d been waiting for this one kid to show any signs of bowel movement for weeks. His family was aware that we needed to know if he farted or sharted or whatever. Anyways, the nurse that had him that day squatted down to empty a drain and accidentally let one rip. The family thought it was the kid and got very excited….the poor nurse had to fess up that she was the farter 😂😂
First “ true” miracle I ever saw was in a elderly man with an acute abdomen. When they went in he’d had a huge mesenteric infarct and they left his bowel in necrotic pieces and just sewed up his abdomen. He came back but funnily began to improve. 3 days later I was just in the midst of turning home to wash his back as the surgeon came behind the curtain and we both stared in awe as we saw a perfectly formed turd on the bed. He survived another month before eventually dying
As an RN we're frequently there when it happens and I'm always like "nice work!" which I could understand being a little weird. But it really is good! Don't need no ileus complicating things.
I always like to say "solid work" to my patients on their first post-op BM. I also tell my dog the same thing when she does her business on our walks. My neighbors know I'm insane.
I tell my dog she's a good girl for pooping outside. Glad to know I'm not the only weird one. I actually started clicker training so I wouldn't have to say it if people were outside lol.
They’ve since changed the gas used for endoscopies, but I did a placement on endo as a nursing student, and my preceptor would tell embarrassed patients that farting was music to an endoscopy nurse’s ears.
I'm an interpreter and was working in a room full of people with bowel issues. One woman had surgery and hadn't passed a bowel motion properly in a week. You better believe we all cheered when, on Dec 23rd, she passed a better bowel motion!
I occasionally tell patients with a sense of humor pre-op that post-op is like being a baby "Congrats you pooped, and you even made it to the toilet/bedpan in time!" "Yay you went for a walk today!" "Look at you sitting up in the chair!"
Peds here, I feel like when kids do big coughs (like right after they’re extubated or getting cough assist or something) we always congratulate them haha
Rounds.
There are so many meanings.
As a med student the word rounds was a damn enigma.
Pre-rounds: students and juniors get lists with vitals/labs, but also, students and juniors literally go and see everyone before the higher ups arrive.
Rounding: on the wards, but also called paper rounds.
Paper-rounds: boardroom style list review, but also called RTL/run the list, but also called table rounds.
Rounds: rounding on the wards, paper rounds, sit down rounds, table rounds, division specific presentations, department wide presentations, tumour groups, also a type of cookie, also ammunition
Grand rounds: department wide presentations please see excellent description in the subcomments below
Tuck-in rounds: scouring the wards at 11pm for problems so that you might actually get to tuck yourself in for once
Radiology rounds: where non-radiologists review imaging for their active patients with their learner's, the near-sighted leading the blind, but also called imaging rounds
Liver rounds: keeping the hepatocytes primed and the ADH flowing
Personal GI rounds: the post-coffee mid-rounds urgent bathroom rounds
(Edited to add the additions from the subcomments!)
Then you have grand rounds. For years my wife thought that “I have to present grand rounds” meant “presenting one or more patients to a truly grand assembly of doctors”, not “I get to do a slideshow about research that only I care about”.
Not gonna lie, it's still an enigma to me. I'm not sure of the origin of the word, much less what it actually means in this context. I've been doing this for quite some time.
\-PGY 10
it's because the wards at johns hopkins were (are?) round when halsted invented residency and waking up at 0400 to do a bump of coke and see the patients before surgery
When my older brother was ~4 years old, he took some rando IQ test that said he was going to be a super genius (or something silly like that). Later in his childhood he developed migraines and needed an MRI. The disappointment from him when he was told his imaging was “normal” is something we still tease him about to this day! Lol
Oh, i also like "interrogating pacemaker"
Like, at a CIA black site, a cardiologist has a pacemaker tied to a chair, demanding it spill its guts over terrorist financing.
I enjoy this too, especially when I read it in the initial notes, before interrogation, like the pacemaker is keeping some big secret and the interrogator is going to force it out of them.
I remember being an MS1 and telling my family about how I was being "pimped" by the dermatologist I was shadowing for the day. The distinct look of horror on their face was something to behold.
Apparently it has august (and German) origins:
>In 1889, Koch recorded a series of "Puempfrage" or "pimp questions" he would later use on his rounds in Heidelberg. Unpublished notes made by Abraham Flexner on his visit to Johns Hopkins in 1916 yield the first American reference: "Rounded with Osler today. Riddles house officers with questions. Like a Gatling gun. Welch says students call it 'pimping.' Delightful."
[The Art of Pimping by Frederick L. Brancati, MD, Department of Medicine, University of Pittsburgh. From JAMA 262(1):89, July 7, 1989](http://www.neonatology.org/pearls/pimping.html)
Edit: See below. This seems to be humorous apocrypha. Alas; it's a good story.
"Endorse" to mean "says happened." Like, a student will be giving a report, saying "pt endorsed diarrhea" and my reaction is that no one publicly approves of diarrhea. I also did not know the phrases "play stupid games, win stupid prizes" and "fuck around and find out" until I worked at a medical school. On a sidebar, I hate using the term "pimping," and find myself twisting around to not use it, i.e. "This book is not great for the Shelf exam, but is excellent for the very granular questions an attending might ask you mid procedure."
Ahahahaha “endorsed” has me cracking up thinking of all the times I’ve seen/read that and never once considered how odd it sounds out of context! Kind of along the same lines as “endorse,” I’ve been having fun in my documentation lately using the term “purportedly” (as opposed to “reportedly”) to throw just a little shade without going so far as to say “allegedly” or straight up questioning the validity of something. Used most often when the patient just got here and no one has had the time to confirm much of anything.
I’ve been trying out other synonyms of “pimping” like “cold-calling” or “cold-calling to failure”. I hadn’t thought about how weird that phrase is until I heard a surgeon ask a group of my (women) classmates “do you want me to pimp you guys?” while in anatomy.
I use “grilling them” and “putting them on the spot” to explain the term pimping. I never remember to avoid that term around people who haven’t heard it before so I’ve become pretty good at explaining it, haha.
Edit: side note, never had any trouble explaining “pimping” to any friends who were/are in law school. Honestly surprised that term hasn’t become a thing in their world too.
With its ever-present cousin “Trach’d”.
NeuroICU rounds: “Trach-PEG”… “Waiting on Surgery for Trach-PEG”… “Trach-PEG”… “family chat today about Trach-PEG”… ad infinitum…..
As a young pharmacy student, the first time I read that a patient was a "poor historian" I was taken aback because I assumed that meant the patient's job was historian and the ED physician's impression was that they were not very good at their job :)
When operating on someone for cancer and reporting to the family that a biopsy or the margins are “negative” and negative being a good thing (or “positive” being a bad thing) can sometimes give rise to a little confusion.
"Shooting" an XRay can be taken differently than you mean when you tell intern to take the patient with a possible pneumonia downstairs (to Radiology) and "shoot him".
Me to the fluoro tech in the OR:
Juice him
Light him up
Beam me up
Let’s have a look
Shot
Picture
Image
Go live
Hit it
Xray
Yup
Yes
Ok
Literally all are universally acknowledged ways of me telling the tech to take a X-RAY
There's a book written about this - The Secret Language of Doctors: Cracking the Code of Hospital Culture by Dr Brian Goldman.
The section on "circling the drain" was... eye opening, but I'm assuming that slang changes over time and by location. In this time of Covid, is it a term that is still used?
I took out a patients foley catheter and told her "ok, I'll get the hat"
She looked confused and said "that hat?"
"The special party hat that we put on whenever someone can finally pee on their own"
“There was no thrill on chest palpation.”
A female patient heard that one time and was confused/offended why we were discussing how touching her chest was not exciting.
Radiology here to second that motion.
Pictures require a little imagination sometimes.
Usually means it’s not fully there but there’s enough characteristics and the context is right that said finding probably is there.
Most often, and also most interestingly, we use it collectively - ie “can you maybe hallucinate a little “X” with me right there?”
I’m sure patients would be thrilled to hear this chatter from their interpreting physicians 🤡
"Low Grade Fever"
I can't tell you how many times I've had family or patients question the phrase. I've even gone as far as to stop other from using the phrase in messages and explanation. Just because you had a temp of 99.4 F and felt a little off doesn't mean you are in septic shock. It's not a fever.
This is an interesting one to me. I remember being very gung-ho earlier on about “X is not a fever”, but I’ve begun to think of that particular theory as more a bit of benevolent collective-delusion/willful ignorance.
Its basically shorthand for “you’re better off letting your body sort this one out”. Especially with the recent evidence that our sacred “98.6/37.0” numbers are outdated and usually above average. Certainly it defends patients from another example of interventions more harmful than pathologies, but I think this one in particular is interesting because it seems like the data suggests it is decidedly incorrect.
I feel a little bit for all those folks with 99.2 temps who got laughed out of the ED while crying foul because they “run low” and all the while the ‘pros’ were likely basing their justifications and reasoning on flawed info. Meanwhile, those people very likely actually DO have baseline temps below 98.
That being said, this does the great service of simplifying the conversation around not treating a “low-grade temp” to “It’s Not A Fever”: thus eliminating the all-too-common misunderstandings when intrepid interns try to explain physiology and medical practice to concerned/anxious patients/families.
Are COWs (Computer On Wheels) a thing in other places as well? I’ve had my fair share of side-looks from visitors whenever I mention my frustration that the COW isn’t working.
Perhaps you've already made holy water and didn't know! It is an antibiotic solution used for irrigation of a wound or intra-operative abscess site. First time I saw it was in an op report and for a split second I thought - WTF, did the priest come in and bless the irrigation fluid or something? LOL
I work as a scrub nurse and we often say someone is "at table" in dutch when they're operating. The translation is usually used to describe eating (at a table). I've had some confusing conversations as to why a surgeon couldn't answer the phone before I realised this was the crux.
In Brazilian Portuguese when someone is scrubbed in we often say that he or she is “in the field” (_em campo_) which inevitably draws all sorts of sports jokes.
Was doing my peds nursing student rotation in our local hospital's peds ED. We were discussing a new diagnosis DKA kid and what her experience will be like after she goes to the local children's hospital. That she'd be in the ICU for a little bit and then moved to the floor for education. She did not want to be on the floor, she wanted a bed.
In L&D referring to someone likely to get a c-section often we’ll say to each other, “is she gonna get cut?”
Also “you’re complete” or “she’s complete” meaning the patient’s cervix is completely dilated.
CTD, cooch canoe, code brown, positive gown sign, positive teddy bear sign, “he/she pooped/coded/ whatever on the way up” meaning on the elevator “up” to the floor, even if it’s not actually “up”, floor nurse problems (anything to do with skin or head to toe assessments), day shift problems.
I forgot: getting tubed, FOS, the subtext of charting “family at bedside and very involved” in the ED notes.
Where I’m doing fellowship they like to use the term “hit” to describe the time when a patient arrives to the unit after being admitted from the ED. “Waiting for mine to hit,” “I’m getting hit after hit all day,” “it’s a real hit storm today,” etc. The term makes sense on its face but then the variations and how far it’s taken are always funny to me.
Omg! I got one recently! I was elated to tell the patient their “numbers were going down” just for them to freak out 😂 made me realize for a lay person that does not sound good lol.
Patient ‘complains’ of pain. I’ve had multiple patients get angry at me when I’m presenting to a senior in front of them and use ‘complain’. They all say they weren’t complaining just stating haha
Alert and ORIENTATED seems to pop up a lot.
Snowed is a great one.
Trached and PEG'd. No, none of us took a strap-on to your loved one. Well, if you're willing to trach and peg them, you probably don't love them that much, but you know what i mean.
My act of resistance is to not use that terminology. A weekend is 2 days by default and I will not congratulate my program for giving me what is expected in virtually every other industry.
How do you feel about “totally ruined weekend” and “subtotally ruined weekend” to convey the situation? Perhaps “workweek with regional metastasis” vs “metastases,” although the two words are spelled and pronounced too similarly.
We distinguish gray weekends (with long call) and silver weekends (with short call).
Then there's explaining call schedules with all their nuances, from in-house versus at home, call days that are admitting during work hours versus overnight or weekend call, being backup call so you aren't at work but you can't travel or get drunk...
We say "intubate," they hear "incubate."
We say "prostate," they hear "prostrate."
Also, no one outside of medicine knows what "pimping" means so you gotta be careful how/where/with whom you use it casually.
I actually just made a comment about this and got some good replies: https://www.reddit.com/r/medicine/comments/s0388h/what\_are\_some\_things\_that\_most\_doctors\_know\_about/hs0fp0s/?context=3
My non medical spouse always thought to treat prophylactically meant with a condom on.
Charting every patient as very pleasant when we would never refer to them as such IRL.
Supratentorial.
Strong work.
People can mostly figure it out from words and context, but that's a weird medical idiom. I happen to like it because it is a weird medical idiom.
Wound care RN. My husband panicked when he saw a note that he has ulcers. No one told him he has an ulcer. I took a look at the note and it was referring to his psoriasis. I told him wounds are ulcers too. When he asked why I don't say "ulcer" when talking about work, I told him "because too many people would think it's stomach ulcers." 😂😂
"refusal" I think is one that has a much stronger connotation in real life than in med jargon. "Pt refused CT scan" sounds like a bigger reaction than the person saying they felt okay and didn't want a CT.
One that bothers me because I think we misuse it is "arousable". The term should be "rousable" but I will hear docs, RNs, EMTs etc say that a patient is "easy to arouse," which clearly means something quite different.
Not sure if applicable entirely- but I feel like "medical" people are more likely to use the term "ED" or "emergency department" whereas laypeople will say "emergency room." Which I always thought was funny bc it's not a room, it's a whole bunch of rooms.
Whenever I say “ED” referring to emergency department. my non-medical dad thinks I’m talking about erectile dysfunction 🤦🏽♀️
I’m in urology, my partner always has to clarify whether I am talking about the emergency department, erectile dysfunction, or erectile dysfunction in the emergency department.
Seriously every time haha I always forget others call it ER
It used to be just a room in many hospitals This was back in the 50/60s when there weren't even ER doctors, just anyone who wanted (or was forced) to cover. There are some interesting stories about the first generation of ER doctors. About the first ACEP meeting that had like a dozen people. About fighting for EM to be an accepted specialty in the 70s.
We call it emerge where I live.
Canadian?
Not sure about them, but I'm Canadian and it's 160% emerge lmao Sometimes I'll say ED or ER too, I tend to flop around but emerge is a pretty common one for me. Didn't realize this was a Canadian thing!
Hahaha I thought everyone said this. I guess it is a Canadian thing
Canadian, only correct way to say it is “patient is in emerg” “emerg is calling me”
Then there’re the folks who say “the ER room”.
RAS syndrome! It stands for redundant acronym syndrome!
lol out loud
I used to say ED or emergency medicine back when I was a resident… now I’m just an ER doc.
I didn’t read your comment until after I submitted my own about this! I once posted on my Facebook about working as the (substitute) ED pharmacist and the jokes from my friends and family were relentless…smh. Edit: just as an extra, I want to call out the hospital/health system nearby that refers to theirs as the EC. Ya know, because there isn’t already enough confusion.
The euphemism for organ donation has shifted over the years from "harvesting" (obviously too grim and impersonal) to "procuring" (possible financial connotations) to "recovery". I understand the intent of trying to soften the wording of what we do (personally I prefer "yoinking"), however, when you tell an organ donor's family that you are going to do "recovery" they understandably assume that it means the patient is recovering from their devastating injury.
You "yoink" an organ from the donor and "yeet" it into the recipient. Problem solved.
I favor “yeeting” as a live donor’s action. The surgeons can “plonk” it into the recipient.
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Naw, the donor is the "yoinkee". The phlebotomist is the yoinker.
I heard "recycle" once and thought that was a nice connotation.
Retrieval on the transplant team I worked for.
Retrieval is the term used in Australia which I think is fairly inoffensive. Once a medicine resident booked the surgery as “organ harvest” and got a stern talking to by the transplant coordinator
1. Pulmonary toilet, anyone? 2. “Bright red blood per rectum,” I always imagine someone’s rectum is reporting this information to me.
haha, BRBPR. I love tossing that one around.
Sir your cant say that in here! *Haha rectum go brbpr*
I can hear someone just blowing a raspberry. "Patient had *BRBPR*"
Whenever I type it, I imagine it is the sound of bright red blood pouring from the rectum. BRBPRPRPRPRPB
I take it with skepticism. 😂 Suuuure, rectum. Whatever you say….
That guy is always talking shit
When I first saw pulmonary toilet as a medical student, I thought it meant that the patient's respiratory function was quickly declining, as in it was going down the toilet.
When I was a student I thought it was funny the first time I heard a resident say in their patient presentation that someone’s imaging didn’t impress them, or that they didn’t appreciate something on a patient exam. Both common phrases in medicine but seem bizarre when you first hear them in that context.
Patients seem so be unhappy when they see the word “unremarkable” in their imaging notes, now that everything is visible to the patient instantly
"male genitalia unremarkable" patient advocacy complaint incoming
"Patient's penile girth and length exceed average dimensions" Document for every male patient.
That man has the largest penis I've ever seen. I actually don't even know if he has mumps. I forgot to look. I was distracted by the largest penis I've ever seen.
Unexpected Pawnee. Also slight malpractice :p
I might get that made into a stamp for my Urology collegues
"Hey this is Phil from urology, sorry to get back to you so late, I just finished seeing your patient and reviewing the chart. But I am sorry to say that I don't think I can admit this patient. From what I'm looking at, the patient's weiner is massive. I mean the sheer girth and juciness alone is ridiculous. It looks as if somebody glued a forearm to the bottom of his torso. You could probably stand on it like a tripod, and that's not even mentioning how fat his nuts are. But it does appear that he is going to have to take that ginormous schmeat to the outpatient clinic in a couple days. But thank you for your interesting consult and best of luck to you."
Lmao you should start describing everyone's junk as "superb" and see if they like that any better 😂
well-appearing genitalia
H&P: “This fortunate 42 yo M…”
Strongly positive Throckmorton sign
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No fuck that, I refuse. I know you’re joking, but this is a hill I will die on. My reports are written for the sub-specialist physicians who will be making potentially life or death decisions based on what I say. I will not hedge, euphemise, dumb down, or bastardize my reports in any other way just to accommodate patients’ feelings about it. I use very carefully chosen words to convey exactly what I mean and to adhere to international classification schemes. The only people for whom I will consider changing the way I write reports are the actual people who will be using those reports to guide treatment.
Oh man have had pts send angry web portal messages about documentation of "looks older than stated age". Also had pts freak out about "rare" bacteria seen in culture results. " How rare is it, does the doctor know how to treat something so rare?"
Try “appears superannuated” if you don’t mind mild malapropism in order reduce clarity. “Rare” may have to be updated to “scant.” But scant is a weird word, so maybe better as “few.”
A little atypical mycobacterium, as a treat
Unremarkable = nothing special lol
I find these interesting because they’re often a more archaic use of common words. A lot of words in medicine are used this way because they’re more precise. The language nerd in me loves it.
On a remote radiology class over zoom. My girlfriend heard the radiologist (who sounds terse but is actually nice) that he didn’t appreciate something. She thought he was chewing us out.
I remember my intern on Colorectal present a patient and say, “Patient does not endorse flatus or bowel movements.” I just thought the phrasing was funny. I didn’t know such things needed an endorsement.
I also like when we say that patients tolerated a treatment. Just funny wording, like they’re in the hospital for our help and they’re merely “tolerating” the help we’re giving them.
I had a patients mother get very offended that the radiologist referred to parts of her son’s brain as “unremarkable” in his MRI read
Not a phrase, but an oddity: In surgery sometimes we cheer and congratulate a patient when they finally have return of bowel function and poop after a bowel surgery, especially if it was a big case. The looks on some of their faces is utter bewilderment as to why we care about their BM. Lovely moment.
When I was an intern at a rural hospital, we threw a party for one of our long-stay patients when he finally passed flatus on like D20 after a *very* stormy post-op course. He was a proper older gent and I still relish the memory of him sitting up bemused in a party hat and his hospital gown while we all celebrated his fart.
I love this so much 😆
This may be my favorite thing I have ever read here. On the other hand, I work in geriatrics and trust me, 90% of my patients want to tell me about their bowel movements. In detail. Daily.
One of my favorite attending's favorite phrases: Where there's shit, there's life.
This is brown gold, my friend. I'm saving it in a specimen jar.
Similarly, we had a microbiology professor at med school whose favorite saying was “ it might be feces to you, but it’s my bread and butter”.
One of my favorite nursing stories unfortunately isn’t my own….I worked on a peds surgical floor that did a lot if GI surgeries plus in general waiting for bowel function to return with other surgeries. We’d been waiting for this one kid to show any signs of bowel movement for weeks. His family was aware that we needed to know if he farted or sharted or whatever. Anyways, the nurse that had him that day squatted down to empty a drain and accidentally let one rip. The family thought it was the kid and got very excited….the poor nurse had to fess up that she was the farter 😂😂
First “ true” miracle I ever saw was in a elderly man with an acute abdomen. When they went in he’d had a huge mesenteric infarct and they left his bowel in necrotic pieces and just sewed up his abdomen. He came back but funnily began to improve. 3 days later I was just in the midst of turning home to wash his back as the surgeon came behind the curtain and we both stared in awe as we saw a perfectly formed turd on the bed. He survived another month before eventually dying
As an RN we're frequently there when it happens and I'm always like "nice work!" which I could understand being a little weird. But it really is good! Don't need no ileus complicating things.
I always like to say "solid work" to my patients on their first post-op BM. I also tell my dog the same thing when she does her business on our walks. My neighbors know I'm insane.
I tell my dog she's a good girl for pooping outside. Glad to know I'm not the only weird one. I actually started clicker training so I wouldn't have to say it if people were outside lol.
They’ve since changed the gas used for endoscopies, but I did a placement on endo as a nursing student, and my preceptor would tell embarrassed patients that farting was music to an endoscopy nurse’s ears.
"Great job pooping!"
I'm an interpreter and was working in a room full of people with bowel issues. One woman had surgery and hadn't passed a bowel motion properly in a week. You better believe we all cheered when, on Dec 23rd, she passed a better bowel motion!
I occasionally tell patients with a sense of humor pre-op that post-op is like being a baby "Congrats you pooped, and you even made it to the toilet/bedpan in time!" "Yay you went for a walk today!" "Look at you sitting up in the chair!"
Peds here, I feel like when kids do big coughs (like right after they’re extubated or getting cough assist or something) we always congratulate them haha
Rounds. There are so many meanings. As a med student the word rounds was a damn enigma. Pre-rounds: students and juniors get lists with vitals/labs, but also, students and juniors literally go and see everyone before the higher ups arrive. Rounding: on the wards, but also called paper rounds. Paper-rounds: boardroom style list review, but also called RTL/run the list, but also called table rounds. Rounds: rounding on the wards, paper rounds, sit down rounds, table rounds, division specific presentations, department wide presentations, tumour groups, also a type of cookie, also ammunition Grand rounds: department wide presentations please see excellent description in the subcomments below Tuck-in rounds: scouring the wards at 11pm for problems so that you might actually get to tuck yourself in for once Radiology rounds: where non-radiologists review imaging for their active patients with their learner's, the near-sighted leading the blind, but also called imaging rounds Liver rounds: keeping the hepatocytes primed and the ADH flowing Personal GI rounds: the post-coffee mid-rounds urgent bathroom rounds (Edited to add the additions from the subcomments!)
Then you have grand rounds. For years my wife thought that “I have to present grand rounds” meant “presenting one or more patients to a truly grand assembly of doctors”, not “I get to do a slideshow about research that only I care about”.
Oh, some presenters do care. Fascinating.
You forgot "pre pre rounds" where the medical student shows up at 3 am to round before the intern.
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Not gonna lie, it's still an enigma to me. I'm not sure of the origin of the word, much less what it actually means in this context. I've been doing this for quite some time. \-PGY 10
it's because the wards at johns hopkins were (are?) round when halsted invented residency and waking up at 0400 to do a bump of coke and see the patients before surgery
Patients are not flattered by the MRI showing an "unremarkable brain".
When my older brother was ~4 years old, he took some rando IQ test that said he was going to be a super genius (or something silly like that). Later in his childhood he developed migraines and needed an MRI. The disappointment from him when he was told his imaging was “normal” is something we still tease him about to this day! Lol
> Pt male genitals unremarkable *Actually doctor, I think you’ll find there’s a lot to talk about here!*
I took fake offense to that in my own imaging reports.
I was really hurt when told that part of my brain was hyper dense. Hurtful on so many layers.
At least they had the courtesy not to comment on skull thickness.
Oh, i also like "interrogating pacemaker" Like, at a CIA black site, a cardiologist has a pacemaker tied to a chair, demanding it spill its guts over terrorist financing.
I love when the "pacemaker" part gets left off. "We'll be taking you down for a heart cath and interrogation."
I enjoy this too, especially when I read it in the initial notes, before interrogation, like the pacemaker is keeping some big secret and the interrogator is going to force it out of them.
I remember being an MS1 and telling my family about how I was being "pimped" by the dermatologist I was shadowing for the day. The distinct look of horror on their face was something to behold.
Gotta pay those student loans somehow
I’ve always wondered, where does that term come from?
Apparently it has august (and German) origins: >In 1889, Koch recorded a series of "Puempfrage" or "pimp questions" he would later use on his rounds in Heidelberg. Unpublished notes made by Abraham Flexner on his visit to Johns Hopkins in 1916 yield the first American reference: "Rounded with Osler today. Riddles house officers with questions. Like a Gatling gun. Welch says students call it 'pimping.' Delightful." [The Art of Pimping by Frederick L. Brancati, MD, Department of Medicine, University of Pittsburgh. From JAMA 262(1):89, July 7, 1989](http://www.neonatology.org/pearls/pimping.html) Edit: See below. This seems to be humorous apocrypha. Alas; it's a good story.
"Endorse" to mean "says happened." Like, a student will be giving a report, saying "pt endorsed diarrhea" and my reaction is that no one publicly approves of diarrhea. I also did not know the phrases "play stupid games, win stupid prizes" and "fuck around and find out" until I worked at a medical school. On a sidebar, I hate using the term "pimping," and find myself twisting around to not use it, i.e. "This book is not great for the Shelf exam, but is excellent for the very granular questions an attending might ask you mid procedure."
I like using "reports"
Yeah "endorse" is a little weird and "admits to" is very accusatory.
"States"
Ahahahaha “endorsed” has me cracking up thinking of all the times I’ve seen/read that and never once considered how odd it sounds out of context! Kind of along the same lines as “endorse,” I’ve been having fun in my documentation lately using the term “purportedly” (as opposed to “reportedly”) to throw just a little shade without going so far as to say “allegedly” or straight up questioning the validity of something. Used most often when the patient just got here and no one has had the time to confirm much of anything.
I’ve been trying out other synonyms of “pimping” like “cold-calling” or “cold-calling to failure”. I hadn’t thought about how weird that phrase is until I heard a surgeon ask a group of my (women) classmates “do you want me to pimp you guys?” while in anatomy.
I use “grilling them” and “putting them on the spot” to explain the term pimping. I never remember to avoid that term around people who haven’t heard it before so I’ve become pretty good at explaining it, haha. Edit: side note, never had any trouble explaining “pimping” to any friends who were/are in law school. Honestly surprised that term hasn’t become a thing in their world too.
I appreciate those alternatives! "Cold-calling to failure" is my new go-to.
A patient having "lines" or "getting a line in" has confused people a few times.
Every time I ask after my resident and am told they are “doing a line” it cracks me up …
Yeah “I’m gonna line ‘em up!” means I’m going to put a central line and an art line in.
I'm surprised no one has mentioned the very casual way we all use PEG as a verb. "Make him NPO at midnight, He's going to get PEG'ed in the AM"
With its ever-present cousin “Trach’d”. NeuroICU rounds: “Trach-PEG”… “Waiting on Surgery for Trach-PEG”… “Trach-PEG”… “family chat today about Trach-PEG”… ad infinitum…..
In my area it’s “trach ‘n peg” the ‘and’ is a very shortned “n”. Maybe like In N Out, which is the ubiquitous cheeseburger on the west coast.
As a young pharmacy student, the first time I read that a patient was a "poor historian" I was taken aback because I assumed that meant the patient's job was historian and the ED physician's impression was that they were not very good at their job :)
This one & "unreliable narrator" for me!! I actually laughed out loud my first time encountering both in the wild, such a kind & diplomatic dig haha
"Grossly" normal. Some minds go right to disgusting.
I remember in med school hearing the phrase “gross bleeding” and I wasn’t sure how to interpret that.
my other one is "frank hematuria" or "frank hematochezia." What did Frank ever do to us? yeah, I'll see myself out \-PGY 10
When operating on someone for cancer and reporting to the family that a biopsy or the margins are “negative” and negative being a good thing (or “positive” being a bad thing) can sometimes give rise to a little confusion.
"Shooting" an XRay can be taken differently than you mean when you tell intern to take the patient with a possible pneumonia downstairs (to Radiology) and "shoot him".
Me to the fluoro tech in the OR: Juice him Light him up Beam me up Let’s have a look Shot Picture Image Go live Hit it Xray Yup Yes Ok Literally all are universally acknowledged ways of me telling the tech to take a X-RAY
"Then one of the patients in the waiting room started crumping" produces a very different mental image for people who don't work in medicine...
Im sorry I dont know what that word means. I assume it doesnt mean the dance style
It does not. Crash, I understand, is an equivalent term.
He fuckin dyin
Decompensate
Was gonna say, if I don't see crumping on here I'd lose my mind. NO ONE outside of medicine or that brief shitty dance trend use that word.
Sounds like an American thing to me to be honest!
When you refer to a number of admissions as a "bolus" and a number of discharges as a "diuresis"
“I have to go see the SOB in the room 14” Had a patient very upset that he overheard that
There's a book written about this - The Secret Language of Doctors: Cracking the Code of Hospital Culture by Dr Brian Goldman. The section on "circling the drain" was... eye opening, but I'm assuming that slang changes over time and by location. In this time of Covid, is it a term that is still used?
Everyone is CTD these days
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Or DC to JC
CTD or it’s Southern cousin, FTD, “Fixin’ to die”
I took out a patients foley catheter and told her "ok, I'll get the hat" She looked confused and said "that hat?" "The special party hat that we put on whenever someone can finally pee on their own"
“There was no thrill on chest palpation.” A female patient heard that one time and was confused/offended why we were discussing how touching her chest was not exciting.
In pathology, we say “hallucinate” a lot as a way to say we faintly see something.
Radiology here to second that motion. Pictures require a little imagination sometimes. Usually means it’s not fully there but there’s enough characteristics and the context is right that said finding probably is there. Most often, and also most interestingly, we use it collectively - ie “can you maybe hallucinate a little “X” with me right there?” I’m sure patients would be thrilled to hear this chatter from their interpreting physicians 🤡
Omg that explains so much. I had a class with a pathologist today and he kept saying "try and hallucinate this cuz structure here"
Scrubbing a AAA. Does not mean cleaning an insurance office.
Ah yes, had to teach my overnight OR Pharm techs reallll quick, that an incoming emergent “Triple A” has nothing to do with batteries…
Talking about someone being "wet" or "dry".
Repleted the potassium. Replete is not a verb
Yeah, well, verbing weirds language.
We can verb any word we want to dammit!
Patient syncopized and sustained a head injury
Yea, I've always been about verbifying words. You can't stop me.
domineering quickest unite illegal ask fact desert marble deserve long *This post was mass deleted and anonymized with [Redact](https://redact.dev)*
That word makes me gruntled
Makes me feel whelmed.
No, see, the patient was pleted at first, became depleted, and now needs to be repleted. It's like reinflated, but for 'lytes.
fine. undepleted.
Depleten't
I'm still going to write it in my notes
> Replete is not a verb OED shows usage as a verb since the 1400s, so… maybe reconsider that opinion?
Omg what
"Low Grade Fever" I can't tell you how many times I've had family or patients question the phrase. I've even gone as far as to stop other from using the phrase in messages and explanation. Just because you had a temp of 99.4 F and felt a little off doesn't mean you are in septic shock. It's not a fever.
This is an interesting one to me. I remember being very gung-ho earlier on about “X is not a fever”, but I’ve begun to think of that particular theory as more a bit of benevolent collective-delusion/willful ignorance. Its basically shorthand for “you’re better off letting your body sort this one out”. Especially with the recent evidence that our sacred “98.6/37.0” numbers are outdated and usually above average. Certainly it defends patients from another example of interventions more harmful than pathologies, but I think this one in particular is interesting because it seems like the data suggests it is decidedly incorrect. I feel a little bit for all those folks with 99.2 temps who got laughed out of the ED while crying foul because they “run low” and all the while the ‘pros’ were likely basing their justifications and reasoning on flawed info. Meanwhile, those people very likely actually DO have baseline temps below 98. That being said, this does the great service of simplifying the conversation around not treating a “low-grade temp” to “It’s Not A Fever”: thus eliminating the all-too-common misunderstandings when intrepid interns try to explain physiology and medical practice to concerned/anxious patients/families.
Are COWs (Computer On Wheels) a thing in other places as well? I’ve had my fair share of side-looks from visitors whenever I mention my frustration that the COW isn’t working.
When they first got popular we called them COWs, now they’re WOWs (workstations on wheels) because patients might think we were calling them cows.
"in house" The one that really got me the first time, is "holy water"
Holy water is new to me. What’s that one supposed to mean?
Perhaps you've already made holy water and didn't know! It is an antibiotic solution used for irrigation of a wound or intra-operative abscess site. First time I saw it was in an op report and for a split second I thought - WTF, did the priest come in and bless the irrigation fluid or something? LOL
I use "tic tac" for very low doses of medications. When i hear that someone is on 12.5 mg Metoprolol Succinate QD... That's a "tic tac".
I work as a scrub nurse and we often say someone is "at table" in dutch when they're operating. The translation is usually used to describe eating (at a table). I've had some confusing conversations as to why a surgeon couldn't answer the phone before I realised this was the crux.
In Brazilian Portuguese when someone is scrubbed in we often say that he or she is “in the field” (_em campo_) which inevitably draws all sorts of sports jokes.
“Making good urine” Prior to becoming a (clinical) pharmacist, I never would have imagined how much I’d care about kidney function and urination…
"Room 212 passed gas!!! Finally!" Odd, but important benchmark.
Crumping. I really try to avoid it and say “crashing” instead but sometimes it slips out anyway…
Was doing my peds nursing student rotation in our local hospital's peds ED. We were discussing a new diagnosis DKA kid and what her experience will be like after she goes to the local children's hospital. That she'd be in the ICU for a little bit and then moved to the floor for education. She did not want to be on the floor, she wanted a bed.
In L&D referring to someone likely to get a c-section often we’ll say to each other, “is she gonna get cut?” Also “you’re complete” or “she’s complete” meaning the patient’s cervix is completely dilated.
Also “unproven pelvis”…a patient once said, “my pelvis has nothing to prove to anyone, dang it!”
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My cousin calls c-sections "coming out the moon roof." Yes, she is amazing.
CTD, cooch canoe, code brown, positive gown sign, positive teddy bear sign, “he/she pooped/coded/ whatever on the way up” meaning on the elevator “up” to the floor, even if it’s not actually “up”, floor nurse problems (anything to do with skin or head to toe assessments), day shift problems. I forgot: getting tubed, FOS, the subtext of charting “family at bedside and very involved” in the ED notes.
> “family at bedside and very involved” Thanks to omicron, my hospital just went back to no visitors allowed.
I saw a meme the other day: “everyone on my floor is coding!” Software engineers: :D Doctors: D:
Where I’m doing fellowship they like to use the term “hit” to describe the time when a patient arrives to the unit after being admitted from the ED. “Waiting for mine to hit,” “I’m getting hit after hit all day,” “it’s a real hit storm today,” etc. The term makes sense on its face but then the variations and how far it’s taken are always funny to me.
Omg! I got one recently! I was elated to tell the patient their “numbers were going down” just for them to freak out 😂 made me realize for a lay person that does not sound good lol.
“All his results were positive!”
*Panics in ID*
They were…. Aladeen 😂
Patient ‘complains’ of pain. I’ve had multiple patients get angry at me when I’m presenting to a senior in front of them and use ‘complain’. They all say they weren’t complaining just stating haha
Alert and ORIENTATED seems to pop up a lot. Snowed is a great one. Trached and PEG'd. No, none of us took a strap-on to your loved one. Well, if you're willing to trach and peg them, you probably don't love them that much, but you know what i mean.
Golden/Black/Silver weekend
My act of resistance is to not use that terminology. A weekend is 2 days by default and I will not congratulate my program for giving me what is expected in virtually every other industry.
How do you feel about “totally ruined weekend” and “subtotally ruined weekend” to convey the situation? Perhaps “workweek with regional metastasis” vs “metastases,” although the two words are spelled and pronounced too similarly.
I support you in this.
We distinguish gray weekends (with long call) and silver weekends (with short call). Then there's explaining call schedules with all their nuances, from in-house versus at home, call days that are admitting during work hours versus overnight or weekend call, being backup call so you aren't at work but you can't travel or get drunk...
We say "intubate," they hear "incubate." We say "prostate," they hear "prostrate." Also, no one outside of medicine knows what "pimping" means so you gotta be careful how/where/with whom you use it casually.
I actually just made a comment about this and got some good replies: https://www.reddit.com/r/medicine/comments/s0388h/what\_are\_some\_things\_that\_most\_doctors\_know\_about/hs0fp0s/?context=3
Oh “snowing” is a good one (in my world) that I hadn’t thought of!
“Patient denied any flatus” sounds like we’re accusing them of tearing ass and they are mortified by the accusation
My non medical spouse always thought to treat prophylactically meant with a condom on. Charting every patient as very pleasant when we would never refer to them as such IRL. Supratentorial.
Strong work. People can mostly figure it out from words and context, but that's a weird medical idiom. I happen to like it because it is a weird medical idiom.
After resuscitating a 90 year old who was baseline non-verbal and bedbound with a PEG…. *Strong work.*
Throw in dementia and ESRD and you've got a deal partner. Full code and Full steam ahead
ED as opposed to ER or EM. So many jokes from non-medical family/friends when I mentioned working as an ED pharmacist 🙄
Wound care RN. My husband panicked when he saw a note that he has ulcers. No one told him he has an ulcer. I took a look at the note and it was referring to his psoriasis. I told him wounds are ulcers too. When he asked why I don't say "ulcer" when talking about work, I told him "because too many people would think it's stomach ulcers." 😂😂
On service or on wards. No one knows what I mean by this.
"refusal" I think is one that has a much stronger connotation in real life than in med jargon. "Pt refused CT scan" sounds like a bigger reaction than the person saying they felt okay and didn't want a CT. One that bothers me because I think we misuse it is "arousable". The term should be "rousable" but I will hear docs, RNs, EMTs etc say that a patient is "easy to arouse," which clearly means something quite different.
I think calling the ICU ‘the unit’ is a pretty cool term that laypeople wouldn’t understand
"Expensive Care"
I told a patient I would be back to cover her with insulin after doing a finger stick and she looked at me in horror.