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Monday, January 26, 2015

Humor: Doctor and cryptic comments

THE doctor purses his lips, looks at you pityingly over his half-moon spectacles and quietly writes something on his clipboard, something short, sharp and authoritative. He turns away to answer the phone and you seize the diversion to sneak a look at your case notes. He has written: "Plumbum oscillans."

What disease can this be? It sounds contagious... maybe even fatal... Is it time to phone friends and family and say farewell? Is your will up to date?


Plumbum oscillans is no threat to health - it is Latin for "swinging the lead," and it is the doctor's discreet way of concluding that you are a malingerer, someone seeking a sick note to take time off work.

These and other terms are part of a secret language, indecipherable to outsiders, that doctors use with each other to convey a truth that is otherwise unsayable, especially to the patient.

The slang can be cruel, insulting and highly inventive, says Adam Fox, a specialist registrar at the Child Allergy Unit at St. Mary's Hospital in London, who has put together a dictionary of the terms.

They include British emergency-room acronyms such as UBI (for "Unexplained Beer Injury"), PAFO ("Pissed And Fell Over") and ATFO ("Asked To F... Off"), not to mention Code Brown, referring to a faecal incontinence emergency.

Then there is DBI, for "Dirtbag Index." This is a formula which multiplies the number of tattoos on the patient's body by the number of missing teeth to estimate the total of days he has gone without a bath.

Relatives of patients on the critical list may blanche if they knew what CTD, GPO or Rule of Five mean on their loved-one's records.

The first means "Circling The Drain," the second signifies "Good for Parts Only" and "Rule of Five" means that if more than five of the patient's orifices are obscured by tubing, he has no chance.

A patient who is "giving the O-sign" is very sick, lying with his mouth open. This is followed by the "Q-sign" -- when the tongue hangs out of the mouth -- when the patient becomes terminal.

General practitioners may use LOBNH ("Lights On But Nobody Home") or the impressively bogus Oligoneuronal to mean someone who is thick.

But they also have a somewhat poetic option: "Pumpkin positive", referring to the idea that the person's brain is so tiny that a penlight shone into his mouth will make his empty head gleam like a Halloween pumpkin.

If a doctor is stumped for what is wrong with his or her patient, they may record GOK, for "God Only Knows."

As for genetic quirks or inbreeding, FLK means "Funny Looking Kid" and NFN signifies "Normal For Norfolk," a rural English county.

Fox says he has a list of more than 200 terms used by medical practitioners in Britain but his collection shows that doctors around the world make up their own versions.

In Brazil, for instance, physicians use the acronym PIMBA for what can be translated as "swollen-footed, drunk, run-over beggar."

Fox agrees that some terms are offensive and even cause confusion to other doctors who are not in the know.

But he asks at least for critics to understand the stress that doctors face every day. And in any case, the colourful language is under threat of dying out because of fears of lawsuits.

"The use of medical slang helps to depersonalise the distress encountered in doctors' everyway working lives," Fox told the British Medical Journal (BMJ) last year.

"It is a way of detaching and distancing oneself from patients' distress through loss, grief, disease, dying and death. Often someone else's pain is too much for us, so we cut up..."

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