The Dying Art of Medical Slang, and a Top Ten List

There is a unique vocabulary created by physicians – mostly for purposes of insulting patients and other doctors – that is in danger of becoming obsolete. While medicine is a profession already rife with acronyms and technical phrases, practitioners throughout the years have invented plenty of their own. Beginning with Samuel Shem’s 1978 novel, The House of God, and continuing with television programs such as ER and Scrubs, some of this boorish speech has made it into the public domain. Because the concept of professionalism is now an integral part of the physician training culture, much of this language has been appropriately deemed politically incorrect, or worse. Being PC wasn’t regarded as terribly important when I began medical school in 1985, and I’ve always enjoyed this jargon. I consider these expressions to be a form of gallows humor rather than frank aspersions, and I think they must be understood in this context. Physicians, especially those working brutally long hours during their residencies and in high-stress areas such as Emergency Departments (ie, not lazy blogging radiologists like me) are usually the originators of these terms. Before it becomes completely unacceptable to do so, I wish to share some of my personal favorites. While numbered like a David Letterman bit, the list below is in no particular order. I have chosen to not include acronyms, as – while probably the most common form of medical slang – they are sometimes hard to decipher and understand. And since the Patch is a family-friendly publication, I also have attempted to exclude anything overtly offensive.

(10) Wallet biopsy. This is a virtual procedure performed on a patient before any medical services are provided. Insurance information and sometimes actual money (ie, items found in a wallet) are collected upfront.

(9) Acute lead poisoning. This is slang for a gunshot wound, hopefully – and sadly – self-explanatory.

(8) Chrome-induced ischemia. This is the symptom of chest pain sometimes described by perpetrators of (9) after being arrested and handcuffed (ie, chrome around the wrists). An underlying medical cause is rarely identified.

(7) Dirt bag index. This is a simple mathematical formula that divides the number of tattoos on a patient by the number of their natural teeth. A high value (ie, lots of tattoos, few teeth) is considered a bad prognostic sign for both the patient and caregivers. While fairly accurate back during my medical school and residency years, I suspect it is far less so in the current world of ubiquitous body art and Lisbeth Salander wannabes.

(6) Gas passer. This is a derogatory nickname for an anesthesiologist. While containing the not-so-subtle suggestion of flatulence, it also addresses the fact that they administer inhaled drugs (ie, gases) when putting patients to sleep during surgery. I am unaware of any scientific studies showing that anesthesiologists fart more than the general population, but one never knows.

(5) Donorcycle. This is an idiom for motorcycle, as accidents involving such are the greatest source of donated organs. Reckless motorcyclists are sometimes referred to “organ donors”, with rainy or otherwise inclement days considered “donor days”.

(4) Frequent flyer. This describes a patient – usually elderly – who is transported to and from the hospital on a regular basis. They are often on a first-name basis with medical center employees.

(3) Liver rounds. This is a staff party or happy hour, so named because liver-damaging alcohol is served. As a senior student, my friends and I were in charge of this at my medical school. I long ago omitted this “honor” from my résumé.

(2) Flea. This is a pejorative term for an internal medicine physician. A flea is usually the last thing to leave a dying dog, an unkind analogy being drawn to internists and patients in similar dire conditions.

(1) Code brown. Hospitals have many official codes, usually broadcast by loudspeaker. Most people are aware that code blue means cardiac arrest and that code red indicates fire. A code brown is unofficial and only announced in the immediate area where a patient has become incontinent of feces and needs to be cleaned. I can attest that these regularly occur in the Radiology Department, often during barium enema examinations.

[Hopefully this has been entertaining and not objectionable. Any and all complaints should be directed to cristel@patch.com ;)]